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The Care Quality Commission gave us an overall rating of REQUIRES IMPROVEMENT in MARCH 2018. Click below or go to https://www.cqc.org.uk/location/1-2172230912 to see the full report.
 

We received a rating of GOOD in 3 areas and a rating of ‘Requires Improvement’ in the remaining 2 areas. However, the majority of the report was very good and we are very happy with the comments in the report from both staff and service users.

The reasons for which are outlined in the report but in short, the key issues were:

· Safeguarding Alerts – we were found to be in breach of a Regulation 18 as we had not submitted safeguarding alerts to CQC. This was due to a misinterpretation of CQC guidelines. We had submitted all safeguarding alerts in a timely manner to the local authority to ensure the safety of all our service users, but had not forwarded them to CQC also. We rectified this immediately during the inspection and submitted all safeguarding notifications to CQC and have been doing so since the inspection.

· Medication – On occasions, staff had not completed Medication Administration Records (MAR) and it was advised that our MAR charts were not as clear as they could be. The main area for concern was PRN medication, which means medications that are prescribed for use ‘as and when required’. We have begun work on this immediately, and have redesigned our Medication Assessment paperwork and our template MAR charts. We intend to re-assess all service users medication paperwork within the next 4 weeks and have all new paperwork entirely rolled out by 1st May 2018. Our Medications Management team will be contacting all our service users to make arrangements for this in the coming weeks. Our staff will all also be completing re-training in medication again to be completed in the next 4 weeks.

We would like to apologise to all staff and service users for the failings identified in the report as this is not the standard we expect to be delivering and will strive to rectify this as soon as timely possible.

We have taken this as a positive experience and are using the recommendations to better our service for both our staff and our service users. We will aim request a re-inspection as soon as possible to ensure the quality of our service is at the optimum level. 

We would like to thank you all for your co-operation and support throughout the inspection and would also like to thank you so very much for the kind comments passed back onto our inspector – we found it very heart-warming to read!